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    Health

    Where Being Gay Is Punishable by Death, Aid Cuts Are ‘Heartbreaking’

    March 4, 20256 Mins Read
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    Where Being Gay Is Punishable by Death, Aid Cuts Are ‘Heartbreaking’
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    In the weeks since President Trump signed an executive order dismantling the U.S. Agency for International Development, Andrea Minaj Casablanca’s phone has been inundated with desperate pleas for help.

    A counselor who works with nonprofits catering to members of Uganda’s embattled L.G.B.T.Q. population, she has fielded urgent requests from people seeking H.I.V. medications, therapy sessions and shelter in the wake of Mr. Trump’s executive order. Ms. Casablanca responded to these calls while grappling with her own crisis: being fired from a job that was funded by U.S.A.I.D.

    “Our whole world has been turned upside down,” Ms. Casablanca, a 25-year-old transgender woman, said on a recent afternoon in Kampala, the capital. “Everyone is in fear of the future.”

    L.G.B.T.Q. people in Uganda have in recent years endured an intensifying crackdown in this conservative East African nation. President Yoweri Museveni signed a law in 2023 that calls for life imprisonment for anyone who engages in same-sex relations in Uganda and up to a decade in prison for anyone who tries to.

    Now, activists say, the U.S.A.I.D. cuts have put them at even greater risk, with shelters underfunded, hundreds of individuals unemployed and many more facing discrimination and violence. Vital medical supplies remain scarce, while members of L.G.B.T.Q. groups increasingly report feeling depressed or suicidal.

    The law also allows for the death penalty for anyone convicted of “aggravated homosexuality,” a sweeping term defined as acts of same-sex relations with minors or disabled people. Mr. Museveni and his government have claimed that homosexuality is a Western phenomenon and that the law protects children and defends the sanctity of the family.

    “This is a reckoning,” said Richard Lusimbo, the founder and director general of the Uganda Key Populations Consortium, a nonprofit promoting L.G.B.T.Q. rights and health.

    “With these programs gone, I worry our communities will be pushed back into disarray and disempowerment,” he added. “It’s heartbreaking.”

    Muhoozi Kainerugaba, Mr. Museveni’s son and the chief of the Ugandan military, urged President Trump to restore aid for those infected with H.I.V., adding, “Our people will be grateful.”

    The United States provides more than $970 million annually in development as well as humanitarian and security assistance to Uganda. In 2023, about $440 million was spent on health programs, followed by emergency relief, agriculture and education services, according to U.S. government data.

    For years, the United States supported L.G.B.T.Q. groups in Uganda through U.S.A.I.D.-funded initiatives, offering H.I.V. treatment, legal training and resources for activism. Previous U.S. governments also condemned human rights violations against gay Ugandans, imposing trade and travel restrictions in response.

    Just days after Mr. Trump took office in January, his administration announced it was halting all foreign aid as it conducted a 90-day audit of spending. Secretary of State Marco Rubio issued a waiver to continue funding lifesaving medicines and medical services, including for H.I.V. and tuberculosis care and treatment.

    But the exemption excluded programs that promoted diversity, equity and inclusion. That meant L.G.B.T.Q. people were unable to receive medication to protect them from H.I.V. infections. Several Ugandan gay rights groups said that, during the audit, they were informed that their projects were permanently terminated because they promoted diversity, equity and inclusion.

    In late February, the Trump administration announced it had completed a review of all U.S. foreign aid and was cutting 90 percent of U.S.A.I.D. programs, including those providing lifesaving medication.

    The rapid loss of aid from the United States has left many gay Ugandans terrified. “It’s like running from one fire to another fire,” said Agy Hrd, the executive director of Africa Queer Network, which works on L.G.B.T.Q. rights in over a dozen African countries.

    Ms. Hrd, who has vigorously campaigned against the anti-homosexuality law in Uganda, said she was attacked and beaten in the country last year. With the sudden funding cuts, she worries that many gay people, especially in rural areas, will get sick or encounter violence and have nowhere to turn for safety or support.

    “I haven’t slept well in weeks,” she said. “We have a big battle ahead of us.”

    An informal survey of 127 nonprofits dealing with L.G.B.T.Q. issues and other at-risk groups carried out by Uganda Key Populations Consortium, Mr. Lusimbo’s organization, showed that 97 percent of them had lost almost all their budgets as a result of the U.S.A.I.D. cuts. Mr. Lusimbo said he had to let most of his staff go in the past month.

    Organizations have begun distributing what few resources they have left, and relying on volunteers to maintain essential services, like finding shelters or delivering testing kits. Brant Luswata, the executive director of Icebreakers Uganda, a gay rights organization, said that as services were eliminated, his group had been asked to return filing cabinets and chairs purchased with American tax dollars.

    Activists said some L.G.B.T.Q. clinics were now charging for services that had previously been free, like H.I.V. testing. Mental health services have been reduced or cut altogether, they said. There are also fears that the abrupt suspension of aid will undo years of progress in teaching Ugandans about safe sex or expose people living with H.I.V. to life-threatening infections because of their weakened immunity.

    “The infections have not gone on a pause just because there’s a 90-day review,” Mr. Lusimbo said. “We live in a global village,” he added. “Everyone’s health is in jeopardy.”

    The conditions for L.G.B.T.Q. Ugandans are so perilous that shelters often move locations frequently or relocate individuals in order to avoid personal attacks or raids from the authorities. Now, some of those shelters are beginning to close.

    Since 2020, approximately three dozen shelters in secret locations across Uganda have protected thousands of gay people from homelessness and violence, according to John Grace, the coordinator of the Uganda Minority Shelters Consortium.

    The shelters relied on intermediaries who received American funding, including from U.S.A.I.D. and the Centers for Disease Control and Prevention. But because of gradual funding cuts and policy changes under the Trump administration, at least a dozen shelters have now closed, said Mx. Grace, who is nonbinary.

    Those that remain are understaffed and overcrowded and have begun turning people away, they said.

    “It’s a total mess,” said Mx. Grace, 32, whose family kicked them out after they came out as nonbinary a few years ago. “These shelters are a lifeline for so many people, and now they’re struggling to survive.”

    For Ms. Casablanca, the counselor, the relentless stream of phone calls shows no sign of letting up. Despite not receiving her $40 monthly paycheck funded by U.S.A.I.D., she has chosen to continue working as a volunteer.

    Across Kampala and other Ugandan cities, she said, L.G.B.T.Q. people are reaching out, worried about where to get medication, condoms, lubricants and tests. Some call in tears, sharing their struggles with fear and isolation, she said. Many, like her, also worry about where their next paycheck will come from or how they will pay rent.

    To make ends meet, she said, she has taken on work as a party decorator. “We need to survive in this darkness,” she said.



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